{"id":6747,"date":"2015-10-23T03:45:15","date_gmt":"2015-10-23T09:45:15","guid":{"rendered":"http:\/\/www.unk.com\/blog\/?p=6747"},"modified":"2024-09-18T02:23:22","modified_gmt":"2024-09-18T08:23:22","slug":"major-depressive-episode","status":"publish","type":"post","link":"https:\/\/www.unk.com\/blog\/major-depressive-episode\/","title":{"rendered":"Major depressive episode"},"content":{"rendered":"
\n

Major depressive episode<\/h1>\n
\n

DSM Classification<\/h4>\n

(The psychiatry bible)<\/em><\/p>\n

Major Depressive Disorder, Single Episode<\/em><\/p>\n

Diagnostic criteria<\/strong><\/p>\n

    \n
  1. \n
      \n
    1. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1)<\/sup> depressed mood or (2)<\/sup> loss of interest or pleasure.<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n

      Note<\/em>: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.<\/p>\n

        \n
      1. \n
          \n
        1. depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.<\/li>\n
        2. markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)<\/li>\n
        3. significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.<\/li>\n
        4. insomnia or hypersomnia nearly every day<\/li>\n
        5. psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)<\/li>\n
        6. fatigue or loss of energy nearly every day<\/li>\n
        7. feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)<\/li>\n
        8. diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)<\/li>\n
        9. recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.<\/li>\n<\/ol>\n<\/li>\n
        10. The symptoms do not meet criteria for a Mixed Episode.<\/li>\n
        11. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.<\/li>\n
        12. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).<\/li>\n
        13. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.<\/li>\n<\/ol>\n

          The Major Depressive Episode is not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia<\/a> , Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.<\/p>\n

          There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode.<\/p>\n

          Note:<\/strong> This exclusion does not apply if all of the manic-like, mixed-like, or hypomanic-like episodes are substance or treatment induced or are due to the direct physiological effects of a general medical condition.<\/p>\n<\/div><\/div>\n

          \n

          Sensible Psychology Definition<\/h4>\n

          Feeling so miserable that you can’t cope with everyday life or enjoy yourself.<\/em><\/p>\n

          The DSM distinguishes a true ‘major depressive episode’ from other psychiatric diagnoses such as bi-polar disorder<\/a> (‘manic depression’) and schizophrenic and other psychotic illnesses. So a major depressive episode is a period of intense sadness (and often other strong emotions such as fear and anger) and loss of motivation in an otherwise healthy individual.<\/p>\n

          How long does a depressive episode need to last to be an ‘episode’? The basis of the DSM’s 2-week minimum is not explained. We know that people can dip in and out of depression for months or even years.<\/p>\n

          Depression is essentially a state of high stress (1)<\/sup> caused by worry, guilt, negative ‘circular’ thinking and poor sleep, leading to emotional and therefore physical exhaustion. (2)<\/sup><\/p>\n

          Depression used to be known as ‘nervous exhaustion’ – in our opinion a much more useful name, as it actually describes what depression is. Stress exhausts the system, leading to the collapse of motivation and energy.<\/p>\n

          Depressed people:<\/p>\n